BLUE MOUNTAIN CLINIC INC: Form 990, tax year 2015
View the entire original 990 at ProPublica ↗
- Organization
- BLUE MOUNTAIN CLINIC INC (EIN 81-0365291)
- Tax period
- 2015-01-01 to 2015-12-31
- Filed
- 2016-05-16
- IRS object ID
- 201611379349305411
- Schema version
- 2015v2.0
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2016-05-16T11:02:58-07:00 | ReturnTs |
| Tax Period End | 2015-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Boyle Deveny & Meyer PC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 305 South 4th East Suite 200 | AddressLine1Txt |
| City | Missoula | CityNm |
| State Abbreviation | MT | StateAbbreviationCd |
| ZIP | 59801 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2015-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 810365291 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BLUE MOUNTAIN CLINIC INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | BLUE | BusinessNameControlTxt |
| Phone | 4067211646 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 610 N CALIFORNIA ST | AddressLine1Txt |
| City | MISSOULA | CityNm |
| State Abbreviation | MT | StateAbbreviationCd |
| ZIP | 59802 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | ANNIE HANSEN | PersonNm |
| Person Title | Executive Dir. | PersonTitleTxt |
| Signature | 2016-05-16 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Jaime Ward CPA | PreparerPersonNm |
| PTIN | P00441760 | PTIN |
| Phone | 4067213555 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2015 | TaxYr |
| Build TS | 2016-09-27 15:27:22Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | ANNIE HANSEN | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 610 N CALIFORNIA ST | AddressLine1Txt |
| City | MISSOULA | CityNm |
| State Abbreviation | MT | StateAbbreviationCd |
| ZIP | 59802 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $1,845,407 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| All Affiliates Included | false | AllAffiliatesIncludedInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | www.bluemountainclinic.org | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1976 | FormationYr |
| Legal Domicile State | MT | LegalDomicileStateCd |
| Activity Or Mission | The mission of Blue Mountain Clinic (BMC) is to provide access to safe, affordable reproductive and primary health care;to provide education on health,reproductive choices and sexuality;to advocate for policies that improve reproductive justice and correct health disparities;and to empower individuals to actively participate in their health care. | ActivityOrMissionDesc |
| Voting Members Governing Body | 9 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 9 | VotingMembersIndependentCnt |
| Total Employee | 30 | TotalEmployeeCnt |
| Total Volunteers | 50 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| PY Contributions Grants | $102,063 | PYContributionsGrantsAmt |
| CY Contributions Grants | $180,234 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $1,480,175 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $1,636,874 | CYProgramServiceRevenueAmt |
| PY Investment Income | -$20 | PYInvestmentIncomeAmt |
| CY Investment Income | $46 | CYInvestmentIncomeAmt |
| PY Other Revenue | $17,803 | PYOtherRevenueAmt |
| CY Other Revenue | $15,344 | CYOtherRevenueAmt |
| PY Total Revenue | $1,600,021 | PYTotalRevenueAmt |
| CY Total Revenue | $1,832,498 | CYTotalRevenueAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $913,883 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $992,105 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $61,666 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $630,056 | PYOtherExpensesAmt |
| CY Other Expenses | $724,051 | CYOtherExpensesAmt |
| PY Total Expenses | $1,543,939 | PYTotalExpensesAmt |
| CY Total Expenses | $1,716,156 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $56,082 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $116,342 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $705,626 | TotalAssetsBOYAmt |
| Total Assets EOY | $813,960 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $151,675 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $143,667 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $553,951 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $670,293 | NetAssetsOrFundBalancesEOYAmt |
| Mission | The mission of Blue Mountain Clinic is to provide access to safe, affordable reproductive and primary health care; to provide education on health,reproductive choices and sexuality; to advocate for policies that improve reproductive justice and correct health disparities; and to empower individuals to actively participate in their health care. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $1,441,732 | ExpenseAmt |
| Desc | Blue Mountain Clinic (BMC) features a multidisciplinary team of physicians, physician assistants, and nurse practitioners who deliver full spectrum, comprehensive care in a personalized and coordinated environment. We provide:Family medicine Primary care services, pediatrics, mens health, preventative care, and on-site lab servicesSexual and reproductive healthcare, including Vasectomy and cervical cancer treatmentLicensed Clinical Social Workers (LCSW) that provide Mental Health therapy LGBT Primary care and counseling First trimester abortion and counselingBMC has provided access to first trimester abortion care with an emphasis on options counseling and birth control selection for 39 years. BMC is currently the only family medicine clinic in Montana providing abortion care on a consistent, daily basis. In 2015, BMC was voted "Best Health Clinic" and Dr. Ravitz was voted "Best Doctor" for the 8th year in a row in the Missoula Independent's reader's poll "Best of Missoula" awards. Also during the year, the fundraiser entitled "Off the Rack" was again a great success. Over 900 supporters attended this fundraising fashion event designed to promote healthy sexuality that goes beyond barriers, gender and stigma. During 2015, BMC continued to expand outreach efforts to activate support for and expand access to healthcare for all Montana area residents. We continued into our third year with the Montana Family Practice Residency program to train resident doctors within our family medicine setting. Many of these residents will eventually practice in rural Montana areas. Continued steps were taken to create a network of advocates in rural health care delivery settings, to increase prevention awareness to underserved regions of Montana and surrounding states, and to improve access to women seeking care by identifying resources to offset financial constraints. Finally, our Outreach/Education Coordinator doubled the amount of student-led discussions about issues that are pertinent to our youth. Topics were expanded to include bullying, anatomy and sexual development, birth control, healthy sexuality, bystander intervention, safe sex and prevention, gender, consent and substance abuse. Topics were also expanded to accommodate youth of all age groups, gender identities and developmental stages. BMC is working tirelessly to educate young people through empowerment and ethics. In the beginning of 2015 BMC decided to rename its education program BLUE youth health - BLUE being an acronym for Being, Learning, Understanding and Education. Each year, BMC staff participates in 20-35 activities for education, advocacy and outreach. Ongoing initiatives include BMC's partnership with Open Aid Alliance. In the summer of 2015 Dr. Joey Banks ecame their Medical Director, which allowed them to expand on their current testing for several sexually transmitted infections. In conjunction, BMC became the treating facility for those testing positive. Dr. Ravitz continues to serve as the Medical Director for several local youth home programs. BMC sees about 9,000 patient visits every year, which allows us to cover the majority of our operating costs. These visits breakdown as follows:Family Medicine (including same day sick visits) - 68%, Gynecology, Contraceptive and Sexual Health - 18%, Mental Health Counseling - 6%, Abortion Care - 8% | Desc |
| Total Program Service Expenses | $1,441,732 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | false | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Temp Or Permanent Endowments | false | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | false | ReportOtherAssetsInd |
| Report Other Liabilities | false | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | false | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | false | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | false | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | Yes (true) | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | false | OperateHospitalInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | false | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Invest Tax Exempt Bonds | false | InvestTaxExemptBondsInd |
| Escrow Account | false | EscrowAccountInd |
| On Behalf Of Issuer | false | OnBehalfOfIssuerInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | false | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | false | RelatedEntityInd |
| Related Organization Ctrl Ent | false | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | false | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 17 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 30 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | false | Form990TFiledInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Form8282 Filed | 0 | Form8282FiledCnt |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Form8899 Filedind | false | Form8899Filedind |
| Form1098 C Filed | false | Form1098CFiledInd |
| DAF Excess Business Holdings | false | DAFExcessBusinessHoldingsInd |
| Taxable Distributions | false | TaxableDistributionsInd |
| Distribution To Donor | false | DistributionToDonorInd |
| Org Filed In Lieu Of Form1041 | false | OrgFiledInLieuOfForm1041Ind |
| Licensed More Than One State | false | LicensedMoreThanOneStateInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 9 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 9 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | false | MembersOrStockholdersInd |
| Election Of Board Members | false | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | false | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (true) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (true) | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | BLUE MOUNTAIN CLINIC | PersonNm |
| Phone | 4067211646 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 610 N CALIFORNIA ST | AddressLine1Txt |
| City | MISSOULA | CityNm |
| State Abbreviation | MT | StateAbbreviationCd |
| ZIP | 59802 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (13 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| MEGAN DISHONG | ||||||||
| Director | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| JULIANNA CROWLEY | ||||||||
| SecR./tREAS | 5.00 | 0.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| ERIN STEUER | ||||||||
| President | 5.00 | 0.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| JASON PARANTO | ||||||||
| Vice President | 5.00 | 0.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| ERIN ROBERTS | ||||||||
| Director | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| LUKE LAUGHLIN | ||||||||
| Director | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| DEANNA JENNESS | ||||||||
| Director | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| SUNDI HAMILTON | ||||||||
| Director | 40.00 | 0.00 | Yes (X) | $28,494 | $0 | $0 | ||
| VICKI THUESEN | ||||||||
| Director | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| ERIN GIEFER | ||||||||
| Director | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| ANNIE HANSEN | ||||||||
| Executive Dir. | 40.00 | 0.00 | $51,441 | $0 | $0 | Yes (X) | ||
| ERIC A RAVITZ | ||||||||
| STAFF | 40.00 | 0.00 | $126,946 | $0 | $0 | Yes (X) | ||
| JOEY BANKS | ||||||||
| STAFF | 40.00 | 0.00 | $125,458 | $0 | $0 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $332,339 | TotalReportableCompFromOrgAmt |
| Indiv Rcvd Greater Than100 K | 2 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | false | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
| Cntrct Rcvd Greater Than100 K | 0 | CntrctRcvdGreaterThan100KCnt |
| All Other Contributions | $180,234 | AllOtherContributionsAmt |
| Total Contributions | $180,234 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | HEALTH CARE DELIVERY | Desc |
| Business | 621110 | BusinessCd |
| Total Revenue Column | $1,636,874 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $1,636,874 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $1,636,874 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $46 | TotalRevenueColumnAmt |
| Exclusion | $46 | ExclusionAmt |
Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Royalties Revenue RoyaltiesRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $28,253 | FundraisingGrossIncomeAmt |
| Fundraising Direct Expenses | $12,909 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $15,344 | TotalRevenueColumnAmt |
| Exclusion | $15,344 | ExclusionAmt |
Net Income From Gaming NetIncomeFromGamingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $0 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,832,498 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $1,636,874 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $15,390 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Foreign Grants ForeignGrantsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Benefits To Members BenefitsToMembersGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $51,441 | TotalAmt |
| Management And General | $38,581 | ManagementAndGeneralAmt |
| Fundraising | $12,860 | FundraisingAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $815,089 | TotalAmt |
| Program Services | $692,826 | ProgramServicesAmt |
| Management And General | $81,509 | ManagementAndGeneralAmt |
| Fundraising | $40,754 | FundraisingAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $28,357 | TotalAmt |
| Program Services | $21,268 | ProgramServicesAmt |
| Management And General | $7,089 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $30,709 | TotalAmt |
| Program Services | $23,032 | ProgramServicesAmt |
| Management And General | $7,677 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $66,509 | TotalAmt |
| Program Services | $49,882 | ProgramServicesAmt |
| Management And General | $16,627 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $25,769 | TotalAmt |
| Management And General | $25,769 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,359 | TotalAmt |
| Program Services | $6,733 | ProgramServicesAmt |
| Management And General | $3,108 | ManagementAndGeneralAmt |
| Fundraising | $518 | FundraisingAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,972 | TotalAmt |
| Program Services | $6,776 | ProgramServicesAmt |
| Management And General | $797 | ManagementAndGeneralAmt |
| Fundraising | $399 | FundraisingAmt |
Royalties RoyaltiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $14,011 | TotalAmt |
| Program Services | $11,208 | ProgramServicesAmt |
| Management And General | $2,102 | ManagementAndGeneralAmt |
| Fundraising | $701 | FundraisingAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,547 | TotalAmt |
| Program Services | $6,547 | ProgramServicesAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $30,077 | TotalAmt |
| Program Services | $25,565 | ProgramServicesAmt |
| Management And General | $3,008 | ManagementAndGeneralAmt |
| Fundraising | $1,504 | FundraisingAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $57,604 | TotalAmt |
| Program Services | $47,528 | ProgramServicesAmt |
| Management And General | $10,076 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES | $277,202 | $277,202 | |
| CONTRACT LABOR | $82,214 | $82,214 | |
| LAB SUPPLIES | $32,696 | $32,696 | |
| OUTSIDE SERVICES | $27,368 | $23,263 | $4,105 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $152,232 | TotalAmt |
| Program Services | $134,992 | ProgramServicesAmt |
| Management And General | $12,310 | ManagementAndGeneralAmt |
| Fundraising | $4,930 | FundraisingAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,716,156 | TotalAmt |
| Program Services | $1,441,732 | ProgramServicesAmt |
| Management And General | $212,758 | ManagementAndGeneralAmt |
| Fundraising | $61,666 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $40,232 | BOYAmt |
| EOY | $120,013 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $100,024 | BOYAmt |
| EOY | $145,264 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $34,877 | BOYAmt |
| EOY | $48,266 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,000 | BOYAmt |
| EOY | $5,000 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $1,126,379 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $630,962 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $525,493 | BOYAmt |
| EOY | $495,417 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $705,626 | BOYAmt |
| EOY | $813,960 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $32,061 | BOYAmt |
| EOY | $50,408 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $119,614 | BOYAmt |
| EOY | $93,259 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $151,675 | BOYAmt |
| EOY | $143,667 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $553,951 | BOYAmt |
| EOY | $670,293 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $553,951 | BOYAmt |
| EOY | $670,293 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $705,626 | BOYAmt |
| EOY | $813,960 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $116,342 | ReconcilationRevenueExpnssAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | false | FSAuditedInd |
| Federal Grant Audit Required | false | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org509a2 | Yes (X) | PubliclySupportedOrg509a2Ind |
Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $99,805 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $97,943 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $114,588 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $102,063 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $180,234 | CurrentTaxYearAmt |
| Total | $594,633 | TotalAmt |
Gross Receipts Admissions GrossReceiptsAdmissionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $1,170,365 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $1,203,577 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $1,308,714 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $1,480,175 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,636,874 | CurrentTaxYearAmt |
| Total | $6,799,705 | TotalAmt |
Gross Receipts Non Unrlt Bus GrossReceiptsNonUnrltBusGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Tax Rev Levied Orgnztnl Bnft509 TaxRevLeviedOrgnztnlBnft509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Govt Furn Srvc Fclts Vl509 GovtFurnSrvcFcltsVl509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $1,270,170 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $1,301,520 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $1,423,302 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $1,582,238 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,817,108 | CurrentTaxYearAmt |
| Total | $7,394,338 | TotalAmt |
Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $80,000 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $69,750 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $78,600 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $72,000 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $151,000 | CurrentTaxYearAmt |
| Total | $451,350 | TotalAmt |
Substantial Contributors Amt SubstantialContributorsAmtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $80,000 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $69,750 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $78,600 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $72,000 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $151,000 | CurrentTaxYearAmt |
| Total | $451,350 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | $6,942,988 | PublicSupportTotal509Amt |
Gross Investment Income509 GrossInvestmentIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $5 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $22 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $15 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | -$20 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $46 | CurrentTaxYearAmt |
| Total | $68 | TotalAmt |
Post1975 UBTI Post1975UBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Investment Income And UBTI InvestmentIncomeAndUBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $5 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $22 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $15 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | -$20 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $46 | CurrentTaxYearAmt |
| Total | $68 | TotalAmt |
Net Income From Other UBI NetIncomeFromOtherUBIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Income509 OtherIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $1,270,175 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $1,301,542 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $1,423,317 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $1,582,218 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,817,154 | CurrentTaxYearAmt |
| Total | $7,394,406 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support CY509 | 0.93900 | PublicSupportCY509Pct |
| Public Support PY509 | 0.94820 | PublicSupportPY509Pct |
| Investment Income CY | 0.00000 | InvestmentIncomeCYPct |
| Thirty Thr Pct Suprt Tests CY509 | Yes (X) | ThirtyThrPctSuprtTestsCY509Ind |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $79,989 | OtherCostOrOtherBasisAmt |
| Book Value | $79,989 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $833,370 | OtherCostOrOtherBasisAmt |
| Depreciation | $428,446 | DepreciationAmt |
| Book Value | $404,924 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $209,245 | OtherCostOrOtherBasisAmt |
| Depreciation | $198,741 | DepreciationAmt |
| Book Value | $10,504 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $3,775 | OtherCostOrOtherBasisAmt |
| Depreciation | $3,775 | DepreciationAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $495,417 | TotalBookValueLandBuildingsAmt |
Schedule G IRS990ScheduleG
| Field | Value | IRS element (for citing) |
|---|---|---|
| Agrmt Prof Fundraising Acty | false | AgrmtProfFundraisingActyInd |
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Event1 | OFF THE RACK | Event1Nm |
| Gross Receipts Event1 | $28,253 | GrossReceiptsEvent1Amt |
| Gross Revenue Event1 | $28,253 | GrossRevenueEvent1Amt |
| Rent Facility Costs Event1 | $2,403 | RentFacilityCostsEvent1Amt |
| Food And Beverage Event1 | $2,222 | FoodAndBeverageEvent1Amt |
| Other Direct Expenses Event1 | $8,284 | OtherDirectExpensesEvent1Amt |
| Gross Receipts Total | $28,253 | GrossReceiptsTotalAmt |
| Gross Revenue Total Events | $28,253 | GrossRevenueTotalEventsAmt |
| Rent Fclty Costs Total Events | $2,403 | RentFcltyCostsTotalEventsAmt |
| Food And Beverage Total Events | $2,222 | FoodAndBeverageTotalEventsAmt |
| Oth Direct Expnss Total Events | $8,284 | OthDirectExpnssTotalEventsAmt |
| Direct Expense Summary Events | $12,909 | DirectExpenseSummaryEventsAmt |
| Net Income Summary | $15,344 | NetIncomeSummaryAmt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part VI, Line 11b: Form 990 Review Process | THE CURRENT BOARD TREASURER REVIEWS THE 990 IN DETAIL WITH THE EXECUTIVE DIRECTOR. A DRAFT OF THE 990 IS THEN PRESENTED TO THE EXECUTIVE COMMITTEE. ANY CHANGES AND/OR SIGNIFICANT INFORMATION THAT IS RELEVANT TO BOARD MEMBERS IS PASSED ON TO THE BOARD FOR DISCUSSION PURPOSES VIA THE TREASURER. |
| Form 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of Conflicts | BOARD MEMBERS AND KEY STAFF MEMBERS ARE ASKED TO DIVULGE ANY POTENTIAL CONFLICTS OF INTEREST PRIOR TO JOINING THE BOARD OR COMMENCING EMPLOYMENT AT THE CLINIC. BOTH BOARD AND STAFF MEMBERS UNDERGO A THOROUGH APPLICATION PROCESS DESIGNED TO PREVENT AND AVOID ANY POTENTIAL CONFLICTS OF INTEREST. |
| Form 990, Part VI, Line 15b: Compensation Review and Approval Process for Officers and Key Employees | COMPENSATION OF THE EXECUTIVE DIRECTOR AND THE MEDICAL DIRECTOR IS SUBJECTED TO ANNUAL REVIEW AND APPROVAL BY THE BOARD OF DIRECTORS. CHANGES TO COMPENSATION BASED ON PERFORMANCE EVALUATIONS, COST OF LIVING INCREASE, OR ANNUAL BUDGET CONSTRAINTS ARE REVIEWED AND VOTED ON BY THE BOARD AS A WHOLE. |
| Form 990, Part VI, Line 19: Other Organization Documents Publicly Available | ANY OF THESE DOCUMENTS ARE READILY AVAILIBLE UPON REQUEST. |